Acupuncture and neuropathic pain management

Abstract

Background: Treatment of neuropathic pain remains challenging because of the difficulty in achieving adequate pain control. Objective: This review focuses on the neurobiological basis of acupuncture and clinical evidence for acupuncture's efficacy for neuropathic pain management. Methods: A search was conducted for preclinical and clinical studies published in English since February 2011. The search included articles in MEDLINE,® EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PubMed, Ovid, Google Scholar, and the Cochrane Library. Selection of studies and data extraction were performed independently by 2 reviewers. Interventions covered included: electroacupuncture (EA), traditional acupuncture, auricular acupuncture, very low-intensity laser irradiation, and apipuncture. Results: The current authors found 30 preclinical and 19 clinical studies. Among the 30 preclinical studies, 26 were on EA, 1 was on traditional acupuncture, 1 was on very low-intensity laser irradiation, and 2 were on apipuncture. Among the 19 clinical studies, 9 were on traditional acupuncture, 2 were on auricular acupuncture, 6 were on transcutaneous electrical nerve stimulation, 1 was on percutaneous electrical nerve stimulation, and 1 was on plum blossom needle therapy. Conclusions: Given that neuropathic pain is complicated and sometimes becomes intractable despite conventional treatment, multimodal approaches are required for managing neuropathic pain effectively. Acupuncture is a useful alternative or adjunctive treatment modality for neuropathic pain management. © Mary Ann Liebert, Inc.